Alignment of CCI total ankle replacements in relation to midterm functional outcome and complication incidence
Tóm tắt
Total ankle arthroplasty is increasingly used as a treatment for end stage ankle arthropathy. The aim of this study was to report the mid-term clinical function and survival results of Ceramic Coated Implant (CCI) ankle replacements and assess the association between the alignment of the CCI total ankle replacements and early functional outcome and complication incidence. Data of 61 patients, who received 65 CCI implants between 2010 and 2016, were obtained from a prospectively documented database. Mean follow-up time was 85.2 months (range 27–99 months). Clinical function was assessed with AOFAS questionnaire and passive range of motion (ROM). Survival analysis and elaborate radiographic analysis was performed. Furthermore, complications and reoperations were recorded for all patients. Progression in ROM was most seen in the first 10 months from 21.8 degrees of passive range of motion preoperative to 27.6 degrees postoperative (p < 0.001), while the mean AOFAS gradually increased during follow-up postoperative from a mean of 40.9 points preoperative to an average of 82.5 but shows a small decline towards the end of follow-up (p < 0.001). During follow-up we recorded 8 failures (12.3%) resulting in a Kaplan-Meier survival analysis of 87.7% with a median follow-up of 85.2 months. We observed excellent clinical results and survival after TAA with the CCI implant with only a low mid-term complication rate. Level III, prospective cohort study.
Tài liệu tham khảo
Barg A, Pagenstert GI, Hugle T, Gloyer M, Wiewiorski M, Henninger HB, Valderrabano V. Ankle osteoarthritis: etiology, diagnostics, and classification. Foot Ankle Clin. 2013;18:411–26.
Jordan RW, Chahal GS, Chapman A. Is end-stage ankle arthrosis best managed with total ankle replacement or arthrodesis? A systematic review. Adv Orthop. 2014;2014:986285.
Gougoulias N, Maffuli N. History of total ankle replacement. Clin Podiatr Med Surg. 2013;30(1):1–20.
Kakkar R, Siddique MS. Stresses in the ankle joint and total ankle replacement design. Foot Ankle Surg. 2011;17(2):58–63.
Michael JM, Golshani A, Gargac S, Goswami T. Biomechanics of the ankle joint and clinical outcomes of total ankle replacement. J Mech Behav Biomed Mater. 2008;1(4):276–94.
Barg A, Elsner A, Anderson AE, Hintermann B. The effect of three-component total ankle replacement malalignment on clinical outcome: pain relief and functional outcome in 317 consecutive patients. J Bone Joint Surg Am. 2011;93(21):1969–78.
Gougoulias N, Khanna A, Maffulli N. How successful are current ankle replacements?: a systematic review of the literature. Clin Orthop Relat Res. 2010;468(1):199–208.
Easley ME, Adams SB Jr, Hembree WC, DeOrio JK. Results of total ankle arthroplasty. J Bone Joint Surg Am. 2011;93(15):1455–68.
Braito M, Dammerer D, Kaufmann G, Fischler S, Carollo J, Reinthaler A, et al. Are our expectations bigger than the results we achieve? A comparative study analysing potential advantages of ankle 407 arthroplasty over arthrodesis. Int Orthop. 2014;38(8):1647–53.
Glazebrook MA, Arsenault K, Dunbar M. Evidence-based classification of complications in total ankle arthroplasty. Foot Ankle Int. 2009;30(10):945–9.
Spirt AA, Assal M, Hansen ST Jr. Complications and failure after total ankle arthroplasty. J Bone Joint Surg Am. 2004;86(6):1172–8.
Watts DT, Moosa A, Elahi Z, Palmer AJR, Rodriguez-Merchan EC. Comparing the results of total ankle arthroplasty vs tibiotalar fusion (ankle arthrodesis) in patients with ankle osteoarthritis since 2006 to 2020- A systematic review. Arch Bone Jt Surg. 2022;10(6):470–9.
Odum SM, Van Doren BA, Anderson RB, Davis WH. In-hospital complications following ankle arthrodesis versus ankle arthroplasty: a matched cohort study. J Bone Joint Surg Am. 2017;99(17):1469–75.
Merrill RK, Ferrandino RM, Hoffman R, Ndu A, Shaffer GW. Comparing 30-day all-cause readmission rates between tibiotalar fusion and total ankle replacement. Foot Ankle Surg. 2019;25(3):327–31.
Gross C, Erickson BJ, Adams SB, Parekh SG. Ankle arthrodesis after failed total ankle replacement: a systematic review of the literature. Foot Ankle Spec. 2015;8(2):143–51.
Rahm S, Klammer G, Benninger E, Gerber F, Farshad M, Espinosa N. Inferior results of salvage arthrodesis after failed ankle replacement compared to primary arthrodesis. Foot Ankle Int. 2015;36(4):349–59.
Kruidenier J, van der Plaat LW, Sierevelt IN, Hoornenborg D, Haverkamp D. Ankle fusion after failed ankle replacement in rheumatic and non-rheumatic patients. Foot Ankle Surg. 2019;25(5):589–93. https://doi.org/10.1016/j.fas.2018.08.007. Epub 2018 Aug 24.
NieuweWerne RA, van Solinge G, Doornberg JN, Sierevelt I, Haverkamp D, Doets HC. Total ankle replacement for posttraumatic arthritis. Similar outcome in postfracture and instability arthritis: a comparison of 90 ankles. Acta Orthop. 2015;86(4):401–6. https://doi.org/10.3109/17453674.2015.1029842.432. Epub 2015 Mar 14.
van Es LJM, van der Plaat LW, Sierevelt IN, Hoornenborg D, Haverkamp D. Long-term follow-up of 254 Ceramic Coated Implant (CCI) evolution total ankle replacements. Foot Ankle Int. 2022;43(10):1285–94.
Rippstein PF, Huber M, Coetzee JC, Naal FD. Total ankle replacement with use of a new three-component implant. J Bone Joint Surg Am. 2011;93(15):1426–35.
Henricson A, Carlsson A, Rydholm U. What is a revision of total ankle replacement? Foot Ankle Surg. 2011;17(3):99–102.
Doets HC, van der Plaat LW, Klein JP. Medial malleolar osteotomy for the correction of varus deformity during total ankle arthroplasty: results in 15 ankles. Foot Ankle Int. 2008;29(2):171–7.
Uçkay I, Pedowitz D, Assal M, Stull JD. What is the optimal protocol for performing Debridement, Antibiotics and Implant Retention (DAIR) in an Infected Total Ankle Arthroplasty (TAA) (Type and Volume of Irrigation Solution, and so on)? Foot Ankle Int. 2019;40(1 suppl):53S-55S.
Valderrabano V, Nigg BM, von Tscharner V, Stefanyshyn DJ, Goepfert B, Hintermann B. Gait analysis in ankle osteoarthritis and total ankle replacement. Clin Biomech. 2007;22(8):894–904.
Undén A, Jehpsson L, Kamrad I, Carlsson Å, Henricson A, Karlsson MK, Rosengren BE. Better implant survival with modern ankle prosthetic designs: 1,226 total ankle prostheses followed for up to 20 years in the Swedish Ankle Registry. Acta Orthop. 2020;91(2):191–6. https://doi.org/10.1080/17453674.2019.1709312. Epub 2020 Jan 13.
SooHoo NF, Zingmond DS, Ko CY. Comparison of reoperation rates following ankle arthrodesis and total ankle arthroplasty. Bone Joint Surg Am. 2007;89(10):2143–9.
Simonson DC, Roukis TS. Incidence of complications during the surgeon learning curve period for primary total ankle replacement: 457 a systematic review. Clin Podiatr Med Surg. 2015;32(4):473–82.
Usuelli FG, Maccario C, Pantalone A, Serra N, Tan EW. Identifying the learning curve for total ankle replacement using a mobile bearing prosthesis. Foot Ankle Surg. 2017;23(2):76–83.
Kamrad I, Henricsson A, Karlsson MK, Magnusson H, Nilsson JA, Carlsson A, et al. Poor prosthesis survival and function after component exchange of total ankle prostheses. Acta Orthop. 2015;86(4):407–11.
Schuberth JM, Wood DA, Christensen JC. Gutter impingement in total ankle arthroplasty. Foot Ankle Spec. 2016;9(2):145–58.
Najefi AA, Ghani Y, Goldberg A. Role of rotation in total ankle replacement. Foot Ankle Int. 2019;40(12):1358–67.
Nunley JA, Adams SB, Easley ME, DeOrio JK. Prospective randomized trial comparing mobile-bearing and fixed-bearing total ankle replacement. Foot Ankle Int. 2019;40(11):1239–48.
Espinosa N, Walti M, Favre P, Snedeker JG. Misalignment of total ankle 473 components can induce high joint contact pressures. J Bone Joint Surg Am. 2010;92(5):1179–87.
Fukuda T, Haddad SL, Ren Y, Zhang LQ. Impact of talar component rotation on contact pressure after total ankle arthroplasty: a cadaveric study. Foot Ankle Int. 2010;31(5):404–11.
Tochigi Y, Rudert MJ, Brown TD, McIff TE, Saltzman CL. The effect of accuracy of implantation on range of movement of the Scandinavian total ankle replacement. J Bone Joint Surg (Br). 2005;87(5):736–40.
Lee KB, Kim MS, Park KS, Cho KJ, Primadhi A. Effect of anterior translation of the talus on outcomes of three-component 482 total ankle arthroplasty. BMC Musculoskelet Disord. 2013;14:260.
Saltzman CL, Tochigi Y, Rudert MJ, McIff TE, Brown TD. The effect of agility ankle prosthesis misalignment on the peri-ankle ligaments. Clin Orthop Relat Res. 2004;424:137–42.
Pyevich MT, Saltzman CL, Callaghan JJ, Alvine FG. Total ankle arthroplasty: a unique design. 2 to 12-year follow-up. J Bone Joint Surg Am. 1998;80(10):1410–20.
Dalat F, Barnoud R, Fessy MH, Besse JL, French Association of Foot Surgery AFCP. Histologic study of periprosthetic osteolytic lesions after AES total ankle replacement. A 22 case series. Orthop Traumatol Surg Res. 2013;99(6 Suppl):S285-95.
Najefi AA, Ghani Y, Goldberg AJ. Bone cysts and osteolysis in ankle replacement. Foot Ankle Int. 2021;42(1):55–61.
Macaulay A, Nandyala SV, Miller CP, Ghorbanhoseini M, Wallay KC, Kwon JY. Potential for bias and the american orthopaedic foot and ankle society ankle-hindfoot scoring system. Foot Ankle Spec. 2018;11(5):416–9.